Orthodontic appliance providing enhanced adhesive cure

ABSTRACT

An orthodontic appliance includes a base with an outer surface, as well as at least one passageway extending through the base. An element is received in each passageway and is made of a material that transmits actinic radiation. The element serves as a window to facilitate the curing of light-curable orthodontic adhesive beneath the appliance base, while simultaneously preventing movement of the adhesive through the passageway. Optionally, one or more optical fibers are provided to facilitate curing of the adhesive.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention broadly relates to appliances that are used during thecourse of orthodontic treatment. More particularly, the inventionrelates to orthodontic appliances such as brackets that are directlybonded to the surfaces of teeth, methods for bonding orthodonticappliances to teeth and methods for making orthodontic appliances.

2. Description of the Related Art

Orthodontic treatment involves the movement of malpositioned teeth toorthodontically correct locations. Orthodontic treatment is oftenundertaken to improve the patient's facial appearance. In addition,orthodontic treatment when completed can provide improved occlusion andhelp avoid undue wear on the teeth enamel that might otherwise createadditional problems in the future.

One type of common orthodontic treatment includes the use of a set oftiny, slotted appliances known as brackets. Each of the brackets ismounted on an outer surface of the patient's tooth, and an archwire isplaced in the slot of each bracket. The archwire forms a track to guidemovement of the brackets such that the associated teeth are brought intopositions of correct alignment. Ends of the archwire are often receivedin small molar appliances, also called buccal tubes, that are mounted onmolar teeth of each dental arch.

Many commercially available orthodontic appliances are adapted to bedirectly bonded to the outer surface of the patient's teeth by anorthodontic bonding adhesive. Some types of orthodontic adhesives areinitially supplied as two separate components, such as CONCISE brandadhesive from 3M Unitek. As the components are mixed together, thecomponents react with each other to form an adhesive that ultimatelyhardens and provides sufficient strength to bond the appliance to thetooth.

Two-component orthodontic adhesives have a certain “working time”.During the working time, the practitioner transfers the mixed adhesiveto the base of the appliance, places the appliance on the tooth andshifts the appliance as may be needed to a desired position on thetooth, all before the adhesive begins to harden. However, if the workingtime is too short or if the practitioner is interrupted during theprocedure, the practitioner may not have sufficient time to preciselyplace the appliance in its intended position on the tooth surface. Onthe other hand, if the working time is too long, there is a risk thatthe appliance will shift from its intended position before the adhesivehardens. Unintentional appliance movement may occur, for example, if theappliance is bumped or jarred, or if the adhesive has a viscosity thatenables the appliance to drift along the surface of the tooth.Unfortunately, appliances that are mispositioned once bonded to theteeth represent a significant nuisance to the practitioner as well as tothe patient, especially in instances when the appliance must be removedfrom the tooth and rebonded at the correct location.

For the reasons set out above, many orthodontic practitioners prefer touse a photopolymerizable adhesive that begins to harden once a source oflight is directed toward the adhesive. Photopolymerizable adhesives,also known as light-curable adhesives, are used by many orthodonticpractitioners because the length of the working time can be chosen asneeded. For example, an appliance with a light-curable adhesive can becarefully placed on the patient's tooth and shifted as desired untilsuch time as the practitioner is satisfied with the position of theappliance. At that time, a source of light is directed toward theadhesive in order to harden the adhesive and quickly fix the applianceto the tooth.

Over the years, many attempts have been made to increase the strength ofthe bond between orthodontic appliances and the associated teeth. Somebrackets, for example, have an outer base surface that is roughened,scribed or dimpled, while other brackets have a base surface thatincludes one or more layers of irregularly shaped fragments or sphericalparticles. Such base surfaces present an increased surface area that isavailable for contact with the adhesive, in order to improve thestrength of the bond between the appliance and the tooth.

Additionally, certain orthodontic appliances have bases that presentundercut regions to receive the adhesive. Once the adhesive hashardened, the adhesive in the undercut regions forms a mechanicalinterlock with the appliance. As an example, the bases of someappliances have a fine mesh metal “screen” or pad that becomes embeddedin the adhesive and provides a mechanical interlock with the adhesiveonce the adhesive has hardened. Other appliances, such as that shown inU.S. Design Pat. No. 290,040, have a series of undercut grooves thatprovide a mechanical interlock with the hardened adhesive. U.S. Pat.Nos. 4,094,068 and 5,435,720 describe appliances having bases withperipheral holes or notches that enable the adhesive to flow through andproduce an enlarged head that serves to improve retention of theappliance on the tooth. Orthodontic appliances may also haveirregularly-shaped fragments or spherical particles that presentundercut regions.

Orthodontic appliances are available in a variety of materials,including metallic materials (such as stainless steel and titanium),plastics (such as filled and/or reinforced polycarbonate) and ceramics(such as monocrystalline and polycrystalline alumina). Some orthodonticpractitioners and patients prefer appliances that are made oftransparent or translucent materials such as certain plastics andceramics, because those appliances can blend in with the color of thepatient's teeth and as a result are less noticeable in the oral cavity.Some orthodontic appliances, such as those described in applicants U.S.Pat. No. 4,954,080, are made of a polycrystalline alumina material thathas sufficient translucency to enable the color of the tooth to bevisible through the appliance in order to provide an enhanced aestheticappearance.

When a photopolymerizable orthodontic adhesive is used in combinationwith an appliance that is made of a translucent or transparent material,light passing through the appliance can normally reach the underlyingadhesive. As a result, the adhesive is usually hardened to a substantialextent under most, if not all, portions of the appliance base. Theextent of hardening of the adhesive helps ensure that the appliance doesnot spontaneously debond from the patient's tooth during the course oforthodontic treatment.

Many practitioners, however, prefer to use orthodontic appliances thatare made of materials other than light-transmissive plastic and ceramicmaterials. For example, a substantial number of orthodontists prefer touse appliances made of stainless steel. Although stainless steelappliances are often not considered aesthetic, many practitioners choosestainless steel appliances because they are relatively inexpensive andyet provide satisfactory control over movement of the associated teeth.

However, stainless steel is an opaque material that blocks passage oflight to underlying areas of the appliance base. As a consequence,portions of photopolymerizable adhesive beneath the base may not harden,especially in areas near the center of the base. Often, the practitionermay direct light toward the adhesive along two or more edges of the baseof metal appliances or attempt to direct light through the patient'stooth enamel. However, such a practice may not harden all of theadhesive beneath the base to a degree necessary to precludeunintentional debonding of the appliance when the appliance is subjectedto a relatively large force.

U.S. Pat. No. 5,711,665, assigned to the assignee of the presentinvention, describes a method and apparatus for bonding orthodonticappliances to teeth. The appliance includes a base with an opening, anda body with a passage aligned with the opening. The passage in theappliance permits light to reach adhesive beneath a central portion ofthe appliance base that would otherwise remain substantially uncured. Asa result, bond strength between the appliance and the tooth is increasedand the likelihood of unintentional, spontaneous debonding of theappliance during the course of treatment is significantly reduced.

While the inventions described in U.S. Pat. No. 5,711,665 constitute asignificant advance in the art, there is a continuing need to improvethe construction of orthodontic appliances and methods of orthodontictreatment. Preferably, such improvements can be adopted with relativelylittle additional expense, and yet significantly enhance the state ofthe art such that the practitioner and the patient can both benefit fromthe improvements.

SUMMARY OF THE INVENTION

The present invention is directed to an orthodontic appliance that has abase and at least one passageway extending through the base. An elementis received in the passageway and is made of a material that transmitsactinic radiation. The element functions as a “window” to enable lightto reach underlying regions of the appliance base so that hardening ofthe adhesive is facilitated. The window also hinders movement of theadhesive through the passageway as the appliance is placed on the toothsurface, such that the necessity of clean-up of adhesive near the frontside of the passageway is avoided.

Optionally, the element is made of a material that slowly releasesfluoride in order to inhibit the formation of caries in the vicinity ofthe appliance. As another option, the element is made of a material thattransmits actinic radiation, but also is tinted to provide a certaincolor when viewed by the practitioner. The color may be selected from aset of colors that are part of a color-coding system to identify certaintypes of appliances, or to identify the type or location of the tooth onwhich the appliance is to be mounted.

As an additional option, the element may include one or more opticalfibers to facilitate transmission of light to the adhesive. As anexample, a number of optical fibers may be embedded within a portion ofthe element that is received in the passageway, and the fibers mayextend radially outwardly toward a periphery of the appliance base. Whenactinic radiation is directed toward the element, a portion of the lightpasses through the fibers and to regions of the adhesive that are remotefrom the passageway.

In more detail, the present invention in one aspect concerns anorthodontic appliance for attachment to a tooth. The appliance includesa base having an outer surface and a body extending from the base in adirection away from the outer surface. The orthodontic appliance alsoincludes a slot next to the body for receiving an archwire, and apassageway extending through the base. The orthodontic applianceadditionally includes an element that extends in the passageway. Theelement is made of a material that transmits actinic radiation.

Another aspect of the invention is directed toward a method of bondingan orthodontic appliance to a tooth. The method includes the act ofproviding an orthodontic appliance having a passageway that extendstoward a base of the appliance and an element extending in thepassageway. The method also includes the acts of placing a quantity ofphotocurable adhesive on the base of the appliance, and placing theappliance on the tooth. The method further includes the act of directingactinic radiation through the passageway and the element in order tofacilitate curing of the adhesive.

An additional aspect of the invention is directed toward an orthodonticassembly. The assembly includes an orthodontic appliance having a basewith an outer surface. The assembly also includes an orthodonticadhesive that extends along at least a portion of the outer surface. Theassembly further includes at least one optical fiber that is received inthe adhesive and extends along the base.

The present invention is also directed toward a method of bonding anorthodontic appliance to a tooth. This method includes the acts ofproviding an orthodontic appliance having a base with an outer surface,and placing a quantity of light-curable adhesive on the outer surface.The method also includes the acts of placing at least one optical fiberin the adhesive, and positioning the appliance on the tooth. The methodfurther includes the act of directing a source of actinic radiationtoward the at least one optical fiber in order to enhance distributionof the actinic radiation in the adhesive.

The present invention is further directed toward a method of making anorthodontic appliance. This method includes the acts of providing a ringhaving a channel extending along an inner peripheral surface, and makinga series of passageways through the ring in generally radial directions,wherein at least some of the passageways extend into the channel. Themethod also includes the acts of directing a polymeric material into thechannel and into at least some of the passageways, and hardening thepolymeric material. The method further includes the act of shaping anumber of appliance from each ring, wherein each appliance includes aportion of the channel, at least one passageway and a portion of thehardened polymeric material.

Other aspects of the invention are described in more detail below andare illustrated in the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an orthodontic appliance constructed inaccordance with one embodiment of the invention;

FIG. 2 is a front elevational view of the appliance shown in FIG. 1;

FIG. 3 is a side cross-sectional view of the appliance shown in FIGS. 1and 2 and taken along lines 3—3 of FIG. 2;

FIG. 4 is a view somewhat similar to FIG. 3, except that FIG. 4 alsodepicts in schematic form an injector for making an element of theappliance according to one preferred method;

FIG. 5 is a view somewhat similar to FIG. 1, except that FIG. 5 depictsan orthodontic appliance that is constructed in accordance with anotherembodiment of the invention;

FIG. 6 is a view somewhat similar to FIG. 3, except that FIG. 6illustrates an orthodontic appliance constructed in accordance with yetanother embodiment of the invention;

FIG. 7 is a view somewhat similar to FIG. 3, except that FIG. 7 depictsan orthodontic appliance that is constructed in accordance with stillanother embodiment of the invention;

FIG. 8 is a view somewhat similar to FIG. 2, except that FIG. 8illustrates an orthodontic appliance that is constructed according to anadditional embodiment of the invention;

FIG. 9 is a view somewhat similar to FIG. 1, except that FIG. 9illustrates an appliance that is constructed according to a furtherembodiment of the invention;

FIG. 10 is a view somewhat similar to FIG. 3, except that FIG. 10 showsan orthodontic appliance with an element that is different than theelement shown in FIG. 3 according to still another embodiment of theinvention;

FIG. 11 is an exploded, perspective view depicting a portion of theappliance shown in FIG. 10;

FIG. 12 is a plan view in schematic form of an exemplary dental arch,wherein a number of orthodontic appliance according to an additionalembodiment of the invention are about to be bonded to correspondingteeth of the dental arch using a plurality of optical fibers;

FIG. 13 is a plan view showing a preferred package for initiallycontaining the orthodontic appliance and fibers that are illustrated inFIG. 12;

FIG. 14 is a perspective, exploded view illustrating one step of amethod for making orthodontic appliances according to certainembodiments of the invention;

FIG. 15 is a perspective view showing a later step of the methoddescribed in connection with FIG. 14;

FIG. 16 is a perspective view of an orthodontic appliance made accordingto the methods described in connection with FIGS. 14 and 15; and

FIG. 17 is an exploded perspective view of the orthodontic applianceshown in FIG. 16.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

An orthodontic appliance according to one embodiment of the invention isillustrated in FIGS. 1-3 and is broadly designated by the numeral 20.The appliance 20 in this instance is a bracket that includes a base 22with an outer surface 24 (see FIG. 3). Preferably, the outer surface 24has a compound contour that matches the convex shape of the toothintended to receive the appliance 20. However, the outer surface 24 mayalso be flat or have any other shape as desired.

A body 26 of the appliance 20 extends from the base 22 in a directionaway from the outer surface 24. As an example, if the appliance 20 isintended to be bonded on the facial or buccolabial surfaces of thepatient's teeth, the body 26 extends outwardly from the base 22 in abuccolabial direction. However, the appliance 20 may also be a lingualappliance adapted for bonding to the lingual, or tongue-facing surfacesof a tooth. The base 22 may be integral with the body 26, oralternatively may be manufactured separately and fixed to the body 26 ina subsequent operation (for example, by a spot-welding or brazingprocess).

An elongated archwire slot 28 extends next to the body 26 for receivingan archwire (not shown). In the illustrated embodiment, the body 26includes four tiewings 30, and the archwire slot 28 extends through aspace between adjacent pairs of tiewings 30. However, other embodimentsare also possible. For example, the body 26 may have only one pair oftiewings, and the archwire slot may extend through a space between thosetiewings. As another example, the body 26 may lack an open slot andinstead have a closed slot in the form of a tubular channel forreceiving an archwire, as is found in buccal tube appliances.

As shown for example in FIG. 3, a passageway 32 extends through the base22. In this embodiment, the passageway 32 is located in the center ofthe base 22 and also extends through a central portion of the body 26.However, the passageway 32 may be placed in other locations, and neednot extend through the body 26 if desired.

An element 34 extends through the passageway 32, and preferably is fixedin place in the passageway 32. The element 34 is made of a material thattransmits actinic radiation. The element 34 is capable of transmittingactinic radiation having a wavelength sufficient to initiatepolymerization of a light-curable orthodontic adhesive as will bedescribed in more detail below.

Optionally, the tooth-facing side of the element 34 is flush orapproximately flush with the outer surface 24 as shown in FIG. 3.Preferably, the opposite side (i.e., the “front” side) of the element 34is flush or approximately flush with the surfaces surrounding theentrance to the passageway 32 (in this embodiment, the surfacessurrounding the passageway entrance are located on the central,buccolabial side of the central portion of the body 26). In this manner,the presence of a cavity or recess that might otherwise tend to retainfood or other debris is avoided.

As an additional option, the front side of the element 34 has aconfiguration or structure that facilitates receiving actinic radiation.For example, the front side may have a domed or convex shape that servesto focus or shape the light beam and/or facilitate the reception of alight beam that is somewhat out of alignment with the central axis ofthe passageway 32. As another option, the front side of the element 34may have structure that optically and/or mechanically couples to a lightsource or otherwise enhances the transfer of light from the source ofthe element 34.

The body 26 also includes a pair of elongated grooves 36 that extendfrom the passageway 32. The grooves 36 are optional but are preferablyprovided in order to facilitate alignment of the appliance 20 to thelong axis of the patient's tooth. Preferably, the grooves 36 areparallel with the direction of extension of the tiewings 30 away fromthe longitudinal axis of the archwire slot 28.

Optionally, the element 34 presents a color that is visible to thepractitioner during initial handling and placement of the appliance 20,but does not substantially hinder the passage of actinic radiationthrough the element 34. Preferably, the selected color is one of a setof colors that serve to identify the tooth for which the appliance 20 isintended. For example, a red color may indicate that the appliance 20 isintended for an upper bicuspid tooth while a green color may indicatethat the appliance 20 is intended for an upper cuspid tooth. In thismanner, the appliances are color-coded to facilitate identification andto help ensure that the appliances are mounted on proper, respectiveteeth.

Preferably, but not necessarily, the element 34 includes a pair ofopposed arm portions that are received in the grooves 36. The armportions tend to improve the visibility of the grooves 36, particularlyif the element 34 (including the arm portions) are colored. As a result,identification of the appliance 20 by use of the color-coding describedabove is enhanced and alignment of the appliance 20 with the long axisof the tooth is facilitated.

The element 34 may be manufactured separately and fixed in place in thepassageway 32 by an adhesive, by friction fit or any other suitablemeans. Alternatively, the element 34 may be made by immersing thepassageway 32 in a liquid polymer that ultimately hardens. Preferably,the liquid polymer not only fills the passageway 32 during immersion,but also fills the grooves 36.

An alternative method for making the element 34 is illustratedschematically in FIG. 4. As shown, a nozzle 40 having an outer end thatmatches the shape of the passageway 32 in the grooves 36 is placed overthe body 26 in sealed relation. A quantity of curable polymeric material42 is directed through the nozzle 40 and into the passageway 32 as wellas into the grooves 36.

As depicted in FIG. 4, a stop 44 is placed against the outer surface 24in an area surrounding the passageway 32. The stop 44 serves to preventthe polymeric material 42 from escaping the passageway 32. The stop 44is held in place until the polymeric material 42 has hardened.Optionally, the stop 44 has a roughened surface that faces thepassageway 32, so that the polymeric material 42 also has a roughenedsurface once it has hardened. The roughened surface of the resultingelement 34 serves to enhance the bond of the polymeric element 34 to theorthodontic adhesive that is used to bond the appliance 20 to thepatient's tooth.

An example of a suitable polymeric material for making the element 34 isTRANSBOND™ orthodontic adhesive primer from 3M Unitek. Preferably, aquantity of fluoride is added to the polymeric material prior toplacement of the material in the passageway 32. The fluoride preferablyreleases relatively slowly from the polymeric material during the courseof orthodontic treatment, in order to provide a source of fluoride toadjacent enamel surfaces of the patient's teeth and reduce thelikelihood of caries formation. The formation of caries is a particularproblem with orthodontic patients, because the appliances, archwires andother orthodontic devices in the oral cavity may tend to retain orentrap food.

The source of fluoride may be an inorganic fluoride source, an organicfluoride source or both. Inorganic fluoride salts include simple andcomplex metal fluoride salts as well as fluoride glasses, e.g.,fluoroaluminosilicate glass. Particularly preferred inorganic sources offluoride include silanol treated fluoroaluminosilicate glass fillerssuch as described in U.S. Pat. No. 5,332,429, the disclosure of which isexpressly incorporated by reference herein. Particularly preferredorganic sources of fluoride include tetrafluoroborate salts such asdescribed in U.S. Pat. No. 4,871,786, the disclosure of which is alsoexpressly incorporated by reference herein.

An example of a preferred polymeric material containing a source offluoride is set out below, in parts by weight:

TABLE I INGREDIENT PARTS hydroxy ethyl methacrylate (“HEMA”) 62.9virebond co-polymer (“VBC”) 20.96 glyceryl dimethacrylate (“GDMA”) 10.48dimethylaminoethyl methacrylate methyl tetrafluoroborate 2.52 (“DMAEMA”)camphorquinone (“CPQ”) 0.52 ethyl-4-dimethylaminobenzoate (“EDMAB”) 0.52diphenyliodonium hexafluorophosphate (“DPIHFP”) 1.05 distilled water2.52

The use of DMAEMA, as exemplified in Table I, is an advantage becauseDMAEMA is a monomer and as a result cures with the other monomercomponents to create a highly crosslinked matrix. Since DMAEMA dissolvesin the other monomers, the resulting cured polymeric material is highlytransparent and provides relatively little scattering of light.

As yet another option, a composition containing fluoride could be placedon the appliance 20 in an operation distinct from making the element 34.For example, the element 34 could be made by immersing the passageway 32(and preferably the grooves 36) in a liquid polymer as described above,and subsequently a quantity of fluoride composition could be placed on asurface of the element 34 or another surface of the appliance 20. Thefluoride composition could be added by immersing the appliance or byspraying a liquid composition containing fluoride onto all or a portionof the appliance 20, with or without the use of a robotic arm. Ifdesired, the element 34 could be slightly smaller than illustrated inthe drawings and the fluoride composition placed on the element 34 inthe passageway 32 in sufficient quantity to render the outer surface ofthe composition containing the fluoride in flush relation with adjacentsurfaces of the appliance 20. In this instance, the compositioncontaining the fluoride should be capable of transmitting actinicradiation so that it does not impair the function of the element 34.

Other materials for making the element 34 may also be used. An exampleof a suitable alternative material is an orthodontic glass ionomercement such as Fuji “Ortho LC” brand cement from GC Dental Company.Preferably, the cement includes a quantity of fluoride. Anotheralternative material is polycarbonate, such as a “CD grade”polycarbonate having good optical characteristics.

The base 22 and the body 26 may be made of any one of a number ofmaterials. For example, the base 22 and the body 26 may be integrallymade of a metallic material such as stainless steel Series 300, Series400 or 17-4 PH. The base 22 and the body 26 may be machined, or may bemolded using, for example, a metal injection molding process. As analternative to stainless steel, the base 22 and the body 26 may be madeof other alloys including alloys containing titanium. As an additionaloption, the base 22 and the body 26 may be made of a precipitationhardening martensitic alloy such as described in applicant's PCTApplication No. US00/28456.

As another alternative, the base 22 and the body 26 may be manufacturedas two initially separate components that are subsequently fixed to eachother. For example, the body 26 could be made of any one of thematerials described above, and the base 22 may be made of a materialthat resembles a fine wire mesh screen. Optionally, a layer of metallicfoil extends between the wire screen and the body 26. If the base 22 ismade of a wire mesh, the base 22 may be fixed to the body 26 by abrazing process.

When the base 22 and the body 26 are manufactured as two initiallyseparate components, an automated assembly process may be employed tojoin the components together. For example, a first holding tool couldhave a pin to enter the portion of the passageway 32 that is in the body26, and also include a bar member that is received in the archwire slot28. The pin and the bar member provide orientation of the body 26relative to the first holding tool. A second holding tool is provided tosupport the base 22 during assembly. Optionally, a number of identicalbases are joined together by runners that were manufactured in aprevious process (e.g. mesh bases and runners that were die-cut from asection of mesh and foil stock). The runners provide alignment of eachbase relative to the second holding tool. Optionally, a pin of thesecond holding tool could enter the portion of the passageway 32 of eachbase to aid in precise alignment of the base with the correspondingbody. A laser welder is then directed toward the base from thetooth-facing side of the appliance in order to join the two partstogether.

To bond the appliance 20 to a tooth, a quantity of orthodontic adhesiveis placed on the outer surface 28 and the appliance 20 is thenpositioned over the selected area of the patient's tooth. Next, theappliance 20 is pressed against the surface of the tooth by fingerpressure. Preferably, a sufficient amount of finger pressure is utilizedand there is a sufficient amount of adhesive present beneath the outersurface 24 such that a portion of the adhesive is extruded along theentire periphery of the base 22. In this manner, the practitioner can beassured that a sufficient amount of adhesive is present to securely bondthe appliance 20 to the tooth. In addition, such practice reduces thelikelihood of gaps or voids between the outer surface 24 and the toothsurface.

Next, the practitioner may review the position of the appliance 20relative to the tooth and shift the appliance 20 as needed in order toplace the appliance 20 in the precise, desired position on the tooth.For example, the practitioner may shift the appliance 20 until thearchwire slot 28 is exactly aligned with the occlusal plane of thepatient and the edges of the tiewings 30 and the grooves 36 are exactlyaligned with the longitudinal axis of the tooth. Once the practitioneris satisfied with the position of the appliance 20, a source of light isdirected toward the adhesive in order to fix the appliance 20 in place.

If desired, the source of light can be initially directed only throughthe element 34 in order to harden only the adhesive directly beneath theelement 34 and temporarily tack the base 22 to the patient's tooth. Theexcess adhesive that was previously extruded from the peripheral edge ofthe appliance base 22 can then be readily removed without dislodging theappliance 20 from its intended position. For example, the practitionermay use a dental explorer or other tool to remove the extruded, uncuredadhesive from the tooth adjacent the peripheral edge of the base 22.

Subsequently, remaining portions of the adhesive between the base 22 andthe tooth are hardened by directing light toward the peripheral edges ofthe base 22. If desired, a different curing light assembly may be usedfor peripheral curing, such as an assembly that emits a greaterintensity of light or a wider beam of light.

As can be appreciated, the element 34 functions as a window to permitthe passage of actinic radiation to portions of the adhesive beneath thepassageway 32. In addition, the element 34 closes and preferably sealsthe passageway 32 shut so that the collection of food or other debris isnot facilitated.

If desired, a curing light assembly having structure that controlsmovement of the appliance 20 and/or provides orientation of theappliance 20 may be utilized as a source of actinic radiation in bondingthe appliance 20 of the present invention. With minor modification, anexample of a suitable curing light assembly is illustrated in U.S. Pat.No. 5,711,665 which is incorporated by reference herein. Preferably, thecuring light assembly described in U.S. Pat. No. 5,711,665 is modifiedsuch that the outer, dome-shaped end portion does not extend as far asshown in that patent so that interference with the element 34 isavoided.

An orthodontic appliance 20 a according to another embodiment of theinvention is illustrated in FIG. 5. Except for the differences describedbelow, the appliance 20 a is identical to the appliance 20. As such, adetailed description of the common aspects need not be repeated.

The appliance 20 a includes a layer 46 a of material that extends alongat least a portion of a base 22 a. Preferably, but not necessarily, thelayer 46 a of material is the same composition as the material of anelement 34 a (which is identical to the element 34 described above). Ifthe material includes fluoride, the layer 46 a advantageously providesan increased area from which fluoride can be released during the courseof treatment.

The layer 46 a may extend along a tooth-facing outer surface (not shown)of the base 22 a, across an opposite surface of the base 22 a (asshown), or both. As an option, the element 34 a and the layer 46 a maybe made by immersing the base 22 a as well as the passageway in areservoir containing a quantity of liquid polymeric material.Optionally, the immersion process can be carried out by use of a roboticarm that grips tiewings of the appliance 20 a. The liquid polymericmaterial is then allowed to harden in order to fix the element 34 a aswell as the layer 46 a in place.

Immersing the base 22 a as well as at least a portion of the body 26 aprovides another important advantage, in that small recesses andcavities in the appliance 20 a are filled. For example, when the base 22a and the body 26 a are initially manufactured as separate componentsand subsequently joined together, a slight gap might exist betweenfacing surfaces of the base 22 a and body 26 a. In that instance, theliquid polymeric material tends to fill the gap and provide a seal. As aconsequence, the formation of corrosion in the gap is hindered and thelikelihood of food accumulation in the gap is reduced.

As an additional option, the base 22 a may be made of one or more layersof fine wire mesh, and the foil backing (normally next to the mesh)omitted. The polymeric material, once hardened, provides a backing forthe mesh. Also, the polymeric material is preferably made of acomposition that securely bonds by forces of adhesion to the orthodonticadhesive that is used to bond the appliance 20 a to the patient's tooth.Preferably, the polymeric material is colorless when hardened orpresents a color that matches the color of the patient's teeth. If thehardened polymeric material is colorless or matches the color of thepatient's teeth, the resulting appearance of the base 22 a may renderthe base 22 a more difficult to see in ordinary view. In that instance,the appliance 20 a will provide a more aesthetic appearance in the oralcavity.

An orthodontic appliance 20 b according to another embodiment of theinvention is illustrated in FIG. 6 in side-cross sectional view. Exceptfor the differences noted below, the orthodontic appliance 20 b is thesame as the appliances 20, 20 a.

The appliance 20 b has a base 22 b as well as a body 26 b. A passageway32 b extends through the base 22 b and the body 26 b. However, at leasta portion of the passageway 32 b has a chamfered configuration such thatthe cross sectional area of the passageway 32 b increases as atooth-facing outer surface 24 b of the base 22 b is approached.Preferably, an element 34 b (which is otherwise identical to the element34) has an outer configuration that matches the internal shape of thepassageway 32 b including the chamfered portion.

In the illustrated embodiment, the portion of the passageway 32 b thatpasses through the base 22 b is chamfered, while the portion of thepassageway 32 b that passes through the body 26 b has a cylindricalconfiguration. However, other constructions are also possible. Forexample, the passageway 32 b may steadily increase in cross-sectionalarea along its entire length as the outer surface 24 b is approached.

The chamfered portion of the passageway 32 b helps to retain element 34b in place in the passageway 32 b. For example, when the appliance 20 bis pressed against the tooth surface, the adhesive that extends acrossthe outer surface 24 b is placed under pressure, which results in acertain amount of pressure being applied to the side of the element 34 bthat is adjacent the outer surface 24 b. The chamfered portion of thepassageway 32 b, in combination with the resulting chamferedcross-sectional area of the element 34 b, ensures that the element 34 bdoes not move in the passageway 32 b in a direction away from the outersurface 24 b during such a bonding procedure.

An orthodontic appliance 20 c according to another embodiment of theinvention is illustrated in FIG. 7. Except as noted below, the appliance20 c is identical to the appliance 20 b described in connection withFIG. 6.

The appliance 20 c has a base 22 c and a body 26 c. A passageway 32 cextends through the base 22 c and the body 26 c. However, the portion ofthe passageway 32 c that extends through the base 22 c has a largercross-sectional area than the cross-sectional area of all portions ofthe passageway 32 c that extends through the body 26 c. The step-wisereduction in cross-sectional area presents a shoulder 33 c in thepassageway 32 c.

The appliance 20 c also includes an element 34 c that is received in thepassageway 32 c. A portion of the element 34 c that is in the passageway32 c preferably has a configuration that matches the configuration ofthe passageway 32 c, including the shoulder 33 c. Other aspects andoptions of the element 34 c are similar to the elements 34, 34 bdescribed above.

The shoulder 33 c helps retain the element 34 c in the passageway 32 c.As a result, when the appliance 20 c is pressed against the toothsurface, the orthodontic adhesive located between the base 22 c andtooth surface does not shift the element 34 c in the passageway 32 c.The shoulder 33 c functions in a manner somewhat similar to the chamferof the passageway 32 b described above.

An orthodontic appliance 20 d according to another embodiment of theinvention is illustrated in FIG. 8. Except as described below, theappliance 20 d is identical to the appliance 20 set out above.

The appliance 20 d includes a base 22 d and a body 26 d that is fixed tothe base 22 d. A passageway 32 d extends through a central portion ofthe body 26 d as well as through a central portion of the base 22 d. Anelement 34 d is received in the passageway 32 d.

The appliance 20 d also includes additional passageways 48 d, 50 d. Inthe illustrated embodiment, two passageways 48 d extend through the base22 d on opposite sides of the passageway 32 d and in alignment withgrooves 36 d. Two passageways 50 d extend through the base 22 d as wellas through the body 26 d in a location underlying an archwire slot 28 d.

Preferably, each of the passageways 32 d, 48 d, 50 d receives an elementthat transmits actinic radiation, such as the element 34 describedabove. Optionally, the passageways 48 d, 50 d are arranged alongreference lines that are useful for aligning the appliance 20 d in acertain orientation for facilitating orthodontic treatment. For example,the passageways 48 d could be arranged along reference lines that areparallel to the long axis of the patient's tooth while the passageways50 d are arranged along a plane that is parallel to the occlusal plane.However, other arrangement, patterns or locations for the passageways 32d, 48 d, 50 d are also possible.

Moreover, a greater or smaller number of passageways may be providedthan the number shown in FIG. 8. Additionally, the central passageway 32d may be omitted if desired. The passageways 32 d, 48 d, 50 d may alsohave a cross-sectional area that is larger or smaller than that shown inthe drawings for exemplary purposes.

The elements received in the passageways 32 d, 48 d, 50 d may becolor-coded if desired as described above in connection with theappliance 20. Since the passageways 48 d are relatively small, theelements in the passageways 48 d will not be readily visible to a casualobserver. The elements in the passageways 50 d will be covered fromordinary view by the archwire, as will the majority of the element thatis received in the passageway 32 d.

An orthodontic appliance 20 e according to yet another embodiment of theinvention is illustrated in FIG. 9. Except as described below, theappliance 20 e is identical to the appliance 20, and may optionallyinclude the aspects mentioned in connection with the appliances 20 a, 20b, 20 c, 20 d if desired. The appliance 20 e has a base 22 e and a body26 e that is fixed to the base 22 e. The appliance 20 e also optionallyhas a passageway 32 e as shown in FIG. 9, and an element 34 e isreceived in the passageway 32 e.

The base 22 e has an array of any small passageways 52 e that extendthrough the base 22 e. The appliance 20 e is depicted for exemplarypurposes with a rectangular array of many small passageways 52 e.However, other arrangements and/or arrays are also possible. Moreover,the passageways 52 e may extend in other portions of the base 22 e,including side portions or alternatively portions that extend along theentire periphery of the base 22 e if desired.

An element is preferably received in each passageway 52 e, and is madeof a material identical to the elements described above such as theelement 34. The large number of passageways 52 e helps facilitatehardening of the orthodontic adhesive along a substantial portion of theouter surface of the base 22 e. The passageways 52 e may be made by amilling or machining operation.

As an additional option, the appliance 20 e may be provided with aspectsof the appliances 20 a, 20 b, 20 c, 20 d and described above. If theappliance 20 is a buccal tube, the passageways are preferably onlypresent in mesial and distal flange portions of the base.

An orthodontic appliance 20 f according to another embodiment of theinvention is illustrated in FIGS. 10 and 11. Except for the differencesnoted below, the appliance 20 f is identical to the appliance 20 set outabove.

The appliance 20 f has a passageway 32 f that receives an element 34 f.The element 34 f in this instance includes one or more protrusions.Preferably, the protrusions are optical fibers 54 f although otherprotrusions are also possible. In the illustrated embodiment, sixoptical fibers 54 f are provided and extend outwardly in a generallyradial direction from the passageway 32 f. However, a greater or smallernumber of optical fibers 54 f may alternatively be provided, and theoptical fibers 54 f may be placed in an arrangement having a somewhatdifferent configuration.

Preferably, the optical fibers 54 f extend in directions from thepassageway 32 f toward a periphery of the appliance base 22 f.Consequently, when actinic radiation is directed toward the facial sideof the element 34 f, a portion of the actinic radiation travels alongthe optical fibers 54 f to regions of the orthodontic adhesive that areremote from the passageway 32 f. As a result, the optical fibers 54 fhelp ensure that a substantial portion, if not all, of the orthodonticadhesive beneath the base 22 f has sufficiently hardened.

Moreover, the optical fibers 54 f function as a support substrate orscrim for the adhesive, a particular advantage when the adhesive has arelatively low viscosity. The optical fibers 54 f help to retain theadhesive in place and prevent drift of the appliance until such time asthe adhesive has hardened. The optical fibers 54 f provide body to theadhesive, and yet do not increase the viscosity of the adhesive. Assuch, the adhesive can readily conform to the exact shape of the toothenamel when the appliance is pressed against the tooth during bonding.

The element 34 f may be made by any suitable technique. In one preferredtechnique, the optical fibers 54 f are initially separate and are placedas a bundle into the passageway 32 f. While the optical fibers 54 f areheld in place in the passageway 32 f, a quantity of liquid polymericmaterial is directed into the passageway 32 f and allowed to harden. Theresulting element 34 f contains embedded fibers 54 f that are securelyconnected to the hardened polymeric material.

As another option, the element 34 f is integrally made as a single,unitary component, with tentacles that extend outwardly to form theoptical fibers 54 f. The element 34 f may be made initially separatefrom the remaining elements of the appliance 20 f, or may be molded inplace in the passageway 32 f if desired. The appliance 20 f may alsoinclude options described in connection with the appliances 20 a-20 ementioned above.

As used herein, “optical fibers” mean any fiber that transmits orfacilitates the transmission of actinic radiation. Optical fibersinclude conventional optical fibers having a cladding or coating, suchas “TECS” brand coated silica/silica fibers from 3M Company. Opticalfibers also include fibers that are uncoated and unclad, since suchfibers may be useful for transmitting actinic radiation to portions ofadhesive that may not otherwise receive such radiation. If the opticalfibers are clad, the cladding may be interrupted by notches, grooves orother structure to facilitate the escape of actinic radiation alongsides of the fiber. The fibers may also be in the form of a woven ornonwoven mesh, optionally along with other types of fibers. If thefibers are in the form of a mesh, the mesh may interlock with theadhesive once the adhesive has hardened in order to increase the bondstrength between the appliance and the tooth.

As an additional option, any of the appliances 20-20 f may include alayer of light-curable adhesive that is pre-coated onto the appliancebefore the appliance is packaged for shipment to the practitioner.Examples of adhesive pre-coated orthodontic appliances and suitableadhesives are described for example in U.S. Pat. Nos. 4,978,007,5,015,180, 5,575,645, and 5,636,736, all of which are expresslyincorporated by reference herein.

As a further option, the appliances 20-20 f may be initially connectedto an optical fiber that leads to a source of actinic radiation. Theoptical fiber in this instance may lead to a source of actinic radiationthat is located either inside or outside of the oral cavity. Preferably,the source of actinic radiation or light source is located outside ofthe patient's oral cavity, so that the light source does notinadvertently contact other appliances in the mouth or cause discomfortto the patient by contacting the patient's lips or cheeks. The opticalfiber is disconnected from the appliance once the orthodontic adhesivehas sufficiently hardened.

An example of appliances connected to optical fibers as mentioned in thepreceeding paragraph is illustrated in FIG. 12. In this example, a setof orthodontic appliances 20 g is provided, one appliance 20 g for eachtooth 56 g of a patient's dental arch. An optical fiber 60 g leads fromeach appliance 20 g to a manifold 62 g. Preferably, but not necessarily,the manifold 62 g is located outside of the patient's oral cavity.

Although not shown in FIG. 12, the manifold 62 g is detachably connectedto a source of actinic radiation. Preferably, the source of radiationhas sufficient intensity, when activated, to cure all of the appliances20 g at once. Once the orthodontic adhesive has sufficiently hardened,the manifold 62 g is disconnected from the source of actinic radiationand each of the optical fibers 60 g is uncoupled from the associatedappliance 20 g.

Preferably, the optical fibers 60 g can be disconnected from theassociated appliances 20 g by simply pulling on each fiber 60 g until itfractures from the associated element of the appliance 20 g. To thisend, each optical fiber 60 g has a rupture or tensile strength that issufficiently low to allow the fiber 60 g to be broken in this mannerwithout pulling the associated appliance 20 g off of the tooth. Ifdesired, a line of weakness may be placed in each optical fiber 60 gnear the associated element of the appliance 20 g to help ensure thatthe fiber 60 g ruptures at a location close to the appliance 20 g.Alternatively, a pair of fine-tipped wire cutters or other suitable handinstrument may be utilized to cut each fiber 60 g at a desired location.

As another option, the fibers 60 g may extend through the passageway ofthe appliance and along the base of the appliance 20 g. As such, theportion of the fiber 60 g that extends along the base of the appliance20 g functions in a manner similar to the optical fibers 54 f that aredescribed above in connection with the appliance 20 f. Preferably, anumber of fibers 60 g extend through each passageway and along the basein radially outwardly fashion. The fibers 60 g are fixed in place once aquantity of polymeric material is placed in the passageway and allowedto harden.

FIG. 13 is an illustration of an exemplary package 63 g for containingthe appliances 20 g and the optical fibers 60 g mentioned above (exceptthat the package that is illustrated contains only ten appliances andnot fourteen appliances). As shown, each of the appliances 20 g isreceived in a well 64 g of a substrate 66 g. Optionally, each of theappliances 20 g is precoated with a layer of light-curable orthodonticadhesive (such as the adhesive mentioned above). A cover (not shown)that is opaque to actinic radiation is then placed over the substrate 66g in such a manner that actinic radiation cannot reach the appliances 20g and the adhesive located within the well 64 g.

The substrate 66 g has a notch or opening 68 g through which the fibers60 g initially extend. The opening 68 g serves to retain the fibers 60 gin a convenient array so that tangling of the fibers is avoided. Amanifold (such as the manifold 62 g) for the fibers 60 g is not shown,but is located on the opposite side of the substrate 66 g.

Another preferred method of manufacturing the orthodontic applianceaccording to the invention (such as the appliances 20-20 g) is shownschematically in FIGS. 14-17. Referring initially to FIG. 14, a ring 70is made of a metallic material such as one of the stainless steelmaterials described above. A channel 72 extends along the innercircumference of the ring 70 and extends in a plane that isperpendicular to a central axis of the ring 70. The channel 72 may beprovided by any suitable process, such as a machining operation.

The ring 70 also includes a series of spaced apart passageways 74 thatpreferably extend radially inwardly toward the central axis of the ring70. In the embodiment illustrated, only four passageways 74 are shown.However, it should be understood in this regard that the greater orsmaller number of such passageways 74 may be provided if desired.

Optionally, the ring 70 also includes a series of holes 76 that extendthrough sides of the ring 70 in directions generally parallel to itscentral axis. For exemplary purposes, the ring 70 shown in FIG. 14 hasbeen provided with eight holes 76, a pair of which straddle eachpassageway 74 in transverse relation. Each of the holes 76 extends fromone side of the ring 70 to the other and also extends into the channel72.

Once the ring 70 is provided with the channel 72, the passageways 74 andthe holes 76, the ring 70 is placed in a mold cavity that is suitablefor injection molding of polymeric material (such as polycarbonate). Thepolymeric material is then directed into the mold cavity where it entersthe channel 72 as well as each passageway 74 and each hole 76. In FIG.14, the component designated 78 represents an example of how thepolymeric material might appear within the mold cavity, although thepolymeric material is shown in exploded format separate from the ring 70for purposes of illustration. The mold and the mold cavity are not shownin FIG. 14, although the shape of the mold cavity is the inverse of theshape of the component 78.

In more detail, the component 78 includes a central section 80 that isformed in an inlet passageway of the mold cavity. The central section 80is connected to an intersecting section 82 that, in turn, leads to fourradial sections 84. Each of the four radial sections 84 extends towardan outer annular section 86 that is formed in the channel 72 of the ring70.

The annular section 86 is connected to four protrusions 88, each ofwhich is received in a respective passageway 74 of the ring 70.Additionally, the annular section 86 is connected to eight crossbarsections 90, each of which is received in a respective hole 76 of thering 70. As the polymeric material is forced into the mold cavity andinto contact with the ring 70, the polymeric material conforms to theshape of the channel 72, the passageways 74 and the holes 76 so that aclose, matching fit between the shape of the ring 70 and the hardenedpolymeric material is attained.

The shape of the mold cavity described in the preceding paragraphs mayvary from the shape selected for exemplary purposes and illustrated inthe drawings. For example, the mold cavity may have additionalpassageways so that additional radial sections similar to radial section84 are presented. Also, the central section 80 and the intersection 82may have shapes other than that shown in the drawings.

Once the polymeric material has hardened, the radial sections 84 aredetached from the annular section 86 so that the radial sections 84, theintersection 82 and the central section 80 may be separated from thering 70. Next, the ring 70 with the remaining portions of the hardenedpolymeric material are mounted in a milling machine for milling oforthodontic appliances. Examples of suitable techniques for ring millingof orthodontic appliances are described, for example, in U.S. Pat. Nos.2,713,720 and 5,395,237, both of which are expressly incorporated byreference herein.

FIG. 15 is an illustration of the ring 70 as it appears during anintermediate stage of the ring milling technique. As depicted in FIG.15, the tiewings, the archwire slot and portions of the body of theappliance have been milled to desired shapes. Next, the ring is milledin order to separate the individual appliances from each other and fromremaining portions of the ring 70. Ring milling may be carried out usingcutting tools such as a lathe, a milling machine or any other suitabletool.

FIG. 16 is an illustration of one of the four orthodontic appliances 20h that is made from the ring 70 shown in FIG. 15. The orthodonticappliance 20 h is similar to the appliances 20-20 g described above, inthat it includes tiewings, an archwire slot and a body. In addition, theappliance 20 h includes a light-transmissive element 34 h made of thepolymeric material described above that was received in the channel 72,the passageways 74 and the holes 76.

FIG. 17 is an illustration of the appliance 20 h shown in FIG. 16,except that the appliance 20 h in FIG. 17 is illustrated in explodedform with the element 34 h apart from remaining portions of theappliance 20 h. As can be appreciated, the portions of the element 34 hthat comprised the crossbar sections 90 mentioned above provide a securemechanical interlock with the remaining, metallic portion of theappliance 20 h. As such, the element 34 h is unlikely to become detachedfrom remaining portions of the appliance 20 h.

Although not shown in the drawings, the appliance 20 h preferablyincludes a base such as the base 22 described in connection with theappliance 20. The base may be a mesh pad or a foil mesh pad that isbrazed or welded to the underside of the body of the appliance 20 h.Other aspects of the appliance 20 h are similar to the aspects of theappliances described above. The element 34 h serves to distributeactinic radiation to various regions of the adhesive underlying theappliance base when the appliance 20 h is bonded to a tooth.

The appliances and the methods described above are representative ofcurrently preferred embodiments of the invention. Those skilled in theart, however, will recognize that a number of modifications andadditions may be made to the illustrated appliances and describedmethods without departing from the essence of the invention. Moreover,the invention is useful with other types of orthodontic appliances aswell, such as buccal tubes, lingual buttons, lingual cleats, surgicalbuttons and surgical cleats. As such, the invention should not be deemedlimited to the specific embodiments that are described in detail above,but instead only by a fair scope of the claims that follow along withtheir equivalents.

What is claimed is:
 1. An orthodontic appliance for attachment to atooth comprising: a base having an outer surface; a body extending fromthe base in a direction away from the outer surface; a slot next to thebody for receiving an archwire; a passageway extending through the base;and an element extending in the passageway, the element being made of amaterial that transmits actinic radiation.
 2. An orthodontic applianceaccording to claim 1 wherein the element closes the passageway.
 3. Anorthodontic appliance according to claim 1 wherein the element is fixedin the passageway.
 4. An orthodontic appliance according to claim 1wherein the material releases fluoride.
 5. An orthodontic applianceaccording to claim 1 wherein the passageway includes at least onetapered portion that increases in cross-sectional area as the outersurface is approached.
 6. An orthodontic appliance according to claim 1wherein the passageway includes at least one shoulder.
 7. An orthodonticappliance according to claim 1 wherein the passageway also extendsthrough the body.
 8. An orthodontic appliance according to claim 7wherein the passageway extends through a central portion of the body. 9.An orthodontic appliance according to claim 1 wherein the appliance is abracket, buccal tube, cleat or button.
 10. An orthodontic applianceaccording to claim 1 and including at least one additional passagewayextending through the base and an element received in each additionalpassageway, each element being made of a material that transmits actinicradiation.
 11. An orthodontic appliance according to claim 1 wherein theelement has a color that contrasts with at least one of the body and thebase.
 12. An orthodontic appliance according to claim 11 wherein thecolor represents a code that identifies one or more teeth.
 13. Anorthodontic appliance according to claim 1 and including one or moregrooves for facilitating alignment of the appliance with the tooth, andwherein each groove receives a material that is the same as the materialof the element.
 14. An orthodontic appliance according to claim 1 andincluding at least one optical fiber extending across at least a portionof the outer surface of the base.
 15. An orthodontic appliance accordingto claim 14 wherein each optical fiber has a first end that is locatednear the passageway.
 16. An orthodontic appliance according to claim 14wherein each optical fiber has a first end that is embedded in theelement.
 17. An orthodontic appliance according to claim 16 wherein thebase has a periphery, and wherein each optical fiber extends toward theperiphery of the base when the appliance is attached to a tooth.
 18. Anorthodontic appliance according to claim 17 wherein the applianceincludes a number of optical fibers that extend radially toward theperiphery of the base when the appliance is attached to a tooth.
 19. Anorthodontic appliance according to claim 1 and including a quantity oflight-curable orthodontic adhesive extending across the base and theelement.
 20. An orthodontic appliance according to claim 1 wherein theappliance also includes a hole extending at an angle relative to thedirection of extension of the passageway and wherein a portion of theelement extends in each hole.
 21. An orthodontic appliance according toclaim 20 wherein at least one hole extends in a direction perpendicularto the direction of extension of the passageway.
 22. An orthodonticappliance according to claim 1 wherein the element includes at least oneprotrusion next to the base.
 23. A method of bonding an orthodonticappliance to a tooth comprising: providing an orthodontic appliancehaving a passageway that extends toward a base of the appliance and anelement extending in the passageway; placing a quantity of light-curableadhesive on the base of the appliance; placing the appliance on a tooth;and directing actinic radiation through the passageway and the elementin order to facilitate curing of the adhesive.
 24. A method of bondingan orthodontic appliance to a tooth according to claim 23 wherein atleast a portion of the element is fixed in the passageway, and whereinthe act of placing a quantity of light-curable adhesive on the base ofthe appliance includes the act of placing a portion of the adhesiveacross at least part of the element.
 25. A method of bonding anorthodontic appliance to a tooth according to claim 23 and including theact of initially placing the appliance in a package after the act ofplacing a quantity of photocurable adhesive on the base of the applianceand prior to the act of placing the appliance on the tooth.
 26. A methodof bonding an orthodontic appliance to a tooth according to claim 23wherein the act of directing actinic radiation to the passageway andthrough the element includes the act of directing at least a portion ofthe actinic radiation through one or more optical fibers.
 27. A methodof bonding an orthodontic appliance to a tooth according to claim 26wherein the act of directing at least a portion of actinic radiationthrough one or more optical fibers includes the act of directing atleast a portion of the actinic radiation through one or more opticalfibers that extend toward a periphery of the base.
 28. A method ofbonding an orthodontic appliance to a tooth according to claim 26wherein the act of directing at least a portion of the actinic radiationthrough one or more optical fibers includes the act of directing atleast a portion of the actinic radiation in a radial direction away fromthe passageway.
 29. An orthodontic appliance for attachment to a toothcomprising: a base having an outer surface; at least one passagewayextending through the base; a body extending from the base in adirection away from the outer surface; an orthodontic adhesive extendingacross at least a portion of the outer surface; and at least one opticalfiber received in the orthodontic adhesive and extending along the base,wherein the at least one optical fiber extends toward the at least onepassageway.
 30. An orthodontic appliance according to claim 29 wherein anumber of optical fibers are provided, and wherein each optical fiberextends radially outwardly from the passageway.
 31. An orthodonticappliance according to claim 29 wherein an element extends in thepassageway, wherein the element is made of a material that transmitsactinic radiation, and wherein the element is connected to each opticalfiber.
 32. An orthodontic appliance according to claim 29 and includinga package surrounding the appliance, wherein the package substantiallyprevents the transmission of actinic radiation to the adhesive.
 33. Amethod of bonding an orthodontic appliance to a tooth comprising:providing an orthodontic appliance having a base with an outer surface;placing a quantity of light-curable adhesive on the outer surface;placing at least one optical fiber in the adhesive; positioning theappliance on the tooth; and directing a source of actinic radiationtoward the at least one optical fiber in order to enhance distributionof the actinic radiation in the adhesive, wherein the act of placing atleast one optical fiber in the adhesive includes the act of placing atleast one optical fiber in a direction extending along the outer surfaceof the base in a radial direction from a central region of the outersurface.
 34. A method of bonding an orthodontic appliance to a toothaccording to claim 23 wherein a number of optical fibers are providedand placed in the adhesive, and wherein each optical fiber extendsradially outwardly from the central region of the outer surface.
 35. Amethod of bonding an orthodontic appliance to a tooth according to claim33 and including the act of initially placing the appliance and theadhesive in a package that hinders passage of actinic radiation prior tothe act of positioning the appliance on the tooth.
 36. A method ofbonding an orthodontic appliance to a tooth according to claim 33wherein the at least one optical fiber in the adhesive extends toward aperiphery of the base.
 37. A method of bonding an orthodontic applianceto a tooth comprising: providing an orthodontic appliance having a basewith an outer surface; placing a quantity of light-curable adhesive onthe outer surface; placing at least one optical fiber in the adhesive;positioning the appliance on the tooth; and directing a source ofactinic radiation toward the at least one optical fiber in order toenhance distribution of the actinic radiation in the adhesive, whereinthe act of directing a source of actinic radiation toward the at leastone optical fiber includes the act of directing a source of actinicradiation through a passageway of the appliance.
 38. A method of bondingan orthodontic appliance to a tooth according to claim 37 wherein theact of placing at least one optical fiber in the adhesive includes theact of placing at least one optical fiber in a direction extending alongthe outer surface of the base.
 39. A method of bonding an orthodonticappliance to a tooth according to claim 38 wherein the at least oneoptical fiber extends in a radial direction from a central region of theouter surface.
 40. A method of bonding an orthodontic appliance to atooth according to claim 37 wherein the act of directing a source ofactinic radiation toward the at least one optical fiber includes the actof directing actinic radiation along the fiber in a radial directionaway from a central region of the outer surface of the base.